Research: ONO and COLLEAGUES,

Listed in Issue 238

Abstract

ONO and COLLEAGUES, (1)Department of Internal Medicine, School of Medicine, Hamamatsu University, Hamamatsu, Japan assessed the clinical significance of CD56 antigen in patients with acute promyelocytic leukemia (APL) prospectively treated with all-trans retinoic acid and chemotherapy.

Background

Expression of CD56 has recently been introduced as one of the adverse prognostic factors in acute promyelocytic leukemia (APL). However, the clinical significance of CD56 antigen in APL has not been well elucidated.

Methodology

The authors assessed the clinical significance of CD56 antigen in 239 APL patients prospectively treated with all-trans retinoic acid and chemotherapy according to the Japan Adult Leukemia Study Group APL97 protocol. All patients were prospectively treated by the Japan Adult Leukemia Study Group APL97 protocol. The median follow-up period was 8.5 years.

Results

Positive CD56 expression was found in 23 APL patients (9.6%). Expression of CD56 was significantly associated with lower platelet count (P = 0.04), severe disseminated intravascular coagulation (P = 0.04), and co-expression of CD2 (P = 0.03), CD7 (P = 0.04), CD34 (P < 0.01) and/or human leukocyte antigen-DR (P < 0.01). Complete remission rate and overall survival were not different between the two groups. However, cumulative incidence of relapse and event-free survival (EFS) showed an inferior trend in CD56(+) APL (P = 0.08 and P = 0.08, respectively). Among patients with initial white blood cell counts of 3.0 × 10(9)/L or more, EFS and cumulative incidence of relapse in CD56(+) APL were significantly worse (30.8% vs 63.6%, P = 0.008, and 53.8% vs 28.9%, P = 0.03, respectively), and in multivariate analysis, CD56 expression was an unfavourable prognostic factor for EFS (P = 0.04).

Conclusion

In conclusion, for APL with higher initial white blood cell counts, CD56 expression should be regarded as an unfavourable prognostic factor.

References

Ono T(1), Takeshita A, Kishimoto Y, Kiyoi H, Okada M, Yamauchi T, Emi N, Horikawa K, Matsuda M, Shinagawa K, Monma F, Ohtake S, Nakaseko C, Takahashi M, Kimura Y,  Iwanaga M, Asou N, Naoe T; Japan Adult Leukemia Study Group. Expression of CD56 is an unfavorable prognostic factor for acute promyelocytic leukemia with higher initial white blood cell counts.  Cancer Sci. 105(1):97-104. doi: 10.1111/cas.12319. Epub 2014 Jan 9. Jan  2014.


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